Effects of statin treatment on cardiac function in patients with chronic heart failure: a meta-analysis of randomized controlled trials

Background

Whether additional benefit can be achieved with the use of statin treatment in patients with chronic heart failure (CHF) remains undetermined.

Hypothesis

Statin treatment may be effective in improving cardiac function and ameliorating ventricular remodeling in CHF patients.

Methods

The PubMed, MEDLINE, EMBASE, and EBM Reviews databases were searched for randomized controlled trials comparing statin treatment with nonstatin treatment in patients with CHF. Two reviews independently assessed studies and extracted data. Weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated using random effects models.

Results

Eleven trials with 590 patients were included. Pooled analysis showed that statin treatment was associated with a significant increase in left ventricular ejection fraction (WMD: 3.35%, 95% CI: 0.80 to 5.91%, P = 0.01). The beneficial effects of statin treatment were also demonstrated by the reduction of left ventricular end‐diastolic diameter (WMD: ?3.77 mm, 95% CI: ?6.24 to ?1.31 mm, P = 0.003), left ventricular end‐systolic diameter (WMD: ?3.57 mm, 95% CI: ?6.37 to ?0.76 mm, P = 0.01), B‐type natriuretic peptide (WMD: ?83.17 pg/mL, 95% CI: ?121.29 to ?45.05 pg/mL, P < 0.0001), and New York Heart Association functional class (WMD: ?0.30, 95% CI: ?0.37 to ?0.23, P < 0.00001). Meta‐regression showed a statistically significant association between left ventricular ejection fraction improvement and follow‐up duration (P = 0.03).

Conclusions

The current cumulative evidence suggests that use of statin treatment in CHF patients may result in the improvement of cardiac function and clinical symptoms, as well as the amelioration of left ventricular remodeling. Copyright © 2011 Wiley Periodicals, Inc. Lei Zhang, MD, Shuning Zhang, MD, and Hong Jiang, MD, contributed equally to this work. This study was supported by the Key Projects in the National Science and Technology Pillar Program in the Eleventh Five‐year Plan Period (No. 2006BAI01A04), National Natural Science Foundation of China (No. 30871073), National High‐Tech Research and Development Program of China (No. 2006AA02A406), and Outstanding Youth Grant from National Natural Science Foundation of China (No. 30725036). This work was not funded by an industry sponsor. The authors have no other funding, ?nancial relationships, or con?icts of interest to disclose. Additional Supporting Information may be found in the online version of this article.